Factors associated with the progression of mild cognitive impairment in patients with atrial fibrillation

Objective. To identify factors associated with the progression of vascular moderate cognitive impairment (MCI) over 36 months, based on analyses of clinical, demographic, neuropsychological, laboratory, and neuroimaging characteristics of patients with atrial fibrillation (AF). Material and methods. Data from outpatient visits between 2019 and 2022 were reviewed. Patients with vascular MCI and AF were identified based on the VasCog criteria, neuropsychological assessments using the Montreal Cognitive Assessment (MoCA; scores 18—25), and national and European clinical guidelines. The study used basic statistics, univariate regression, and binary logistic regression to identify and evaluate the predictors of vascular MCI progression in patients with AF after 36 months. Results. Among the 143 patients with vascular MCI and AF (mean age 57.7±6.2 years), 63 patients (n=90) progressed to MCI by 36 months. Several factors associated with a decline in cognitive function were identified: an ischemic stroke occurring 3 to 6 months prior to enrollment (p=0.001), the presence of five or more lacunar infarctions (p=0.005), hypertension classified as grade II or higher (p=0.002), type 2 diabetes mellitus (p=0.002), a C-reactive protein level exceeding 5 mg/L (p=0.019), memory domain scores on the MoCA below 15 points (p=0.004), and scores on the Hospital Anxiety and Depression Scale (HADS-A) of 11 points or lower (p=0.037). Conclusions. The early identification of factors associated with a poor prognosis for MCI at 36 months may reduce vascular dementia burden among patients with AF.